Covid 19 Coronavirus

*STAY AT HOME – to stop coronavirus from spreading*

Everyone must stay at home to help stop the spread of coronavirus.
This includes people of all ages – even if you do not have any symptoms or other health conditions.

You can only leave your home:

  • to shop for basic essentials – only when you really need to
  • to do one form of exercise a day – such as a run, walk or cycle, alone or with other people you live with
  • for any medical need – for example, to visit a pharmacy or deliver essential supplies to a vulnerable person
  • to travel to and from work – but only where this is absolutely necessary

What to do if you have coronavirus symptoms

Continue to stay at home if you have either:

  • a high temperature
  • a new, continuous cough

To protect others, do not go to the GP surgery, pharmacy or hospital. Stay at home.

Use the 111 online coronavirus service to find out what to do.
Only call 111 if you cannot get help online.

Click for information on:

For latest guidance visit: Dept. of health website

PLEASE NOTE: We have changed our appointments system in response to coronavirus

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New patient registration form

Please fill in the registration form below to register as a patient. You can also download the NHS form to fill out and hand in at reception.

We ask every new patient to fill out this form and hand back to a Patient Assistant once completed. All information is confidential and belongs to you, and will help us to support you to stay fit and well.

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Would you like us to contact you via text message in relation to your health and care and to remind you of your appointments?
Which Health Centre would you like to register with? Read more about our Health Centres here.
Do you have a carer who looks after you?
Do you look after anyone who is ill, frail, disabled or has mental health or emotional support needs, or substance misuse problems?
Do you have any medical problems? Please write them below:
Do you have any repeat medications? If yes, please write them below:
Does anyone in your family have heart disease or stroke?
Up to date tests to find cervical cancer make it the easiest female cancer to catch early. If you are a woman between 25 - 64 years of age, have you had a smear test in the last 3 to 5 years?
Have you had 2 doses of MMR?
If you are under 25 years of age have you had the meningitis vaccine?
We offer all new patients an optional 15 minute new patient health check. In this check, a nurse or health care assistant will take a few measurements including your blood pressure, height and weight. You can also talk about any other areas of your health and wellbeing, including the subjects covered in this form.

Would you like us to book you in a new patient health check?
We recommend a routine sexual health check for those who are sexually active as many people will not suffer from any symptoms of sexually transmitted diseases. This can be done in the form of a blood test or urine test if you are a man, or a cotton bud swab you take yourself if you are a woman.

Would you like us to confidentially book one for you?
Do you smoke?
Are you interested in quitting smoking

You might find that other parts of your life are affecting your physical health. We are here to provide support and guidance in these areas. Please tick every box that sounds interesting, and we’ll put you in touch with one of our team.

Money

Bromley by Bow Centre can support you to manage your money on a low budget, get advice on employment law, access benefits and welfare support, reduce your utility costs and deal with debt.

You can also visit the Financially Inclusive Tower Hamlets website which has lots of information www.fith.org.uk

Housing

The advice team at Bromley by Bow Centre can help you with housing advice. You can also get in touch with your housing provider.

Work

Bromley by Bow Centre employment team can support you to find volunteering or work opportunities in the local area.

Alcohol

Bromley by Bow Centre can support you to manage your money on a low budget, get advice on employment law, access benefits and welfare support, reduce your utility costs and deal with debt.

You can also visit the Financially Inclusive Tower Hamlets website which has lots of information www.fith.org.uk

Computer Skills

If you need support to learn how to use a computer, get online and access social media and other services you can attend digital inclusion classes at Bromley by Bow Centre.

By ticking these boxes you give consent that relevant information from this form will be shared with the service.